| NPI | 1548681786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY MICHELLE LANE Ap RN 860-823-0245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CT 002158) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 002158) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CT 002158) | |
| Enumeration Date | 2013-12-13 |
| Last Update Date | 2014-04-02 |